Tumor Size Question

swl1956

My MRI results from last October (below) mention lesion in right mid gland with a measurement of 1.9 x 1.0 x .09 cm. I'm assuming this is the size of my tumor? Is this a length / width / and height measurement of the tumor? If so, is that considered a smaller or larger tumor? Can anyone help me understand this better?

Findings

Prostate measures 4.8 x 3.9 x 3.6 cm, with a volume of 37cc

Transition Zone: There is evidence of mild BPH. PI-RADS 1

Peripheral Zone: There is a T2 hypointense lesion identified within the right mid gland of the peripheral zone, with prominent associated restricted diffusion, with prominent decreased signal on the ADC maps and increased signal on the diffusion-weighted imaging. This is seen on the axial T2-weighted imaging, series 3 images 17-20, measuring 1.9 x 1.0 x 0.9 cm. There is mild broad based capsular contact noted. No definite involvement of the neurovascular bundle. PI-RADS 4

Seminal vesicles: grossly unremarkable

Bladder: Not well evaluated

Lymph nodes: No pathologically enlarged adenopathy

Bones: No suspicious lesion

jc5549

The PIRAD grade 4 lesion is a fairly large volume tumor for a gland that is only 37cc in size. If you've had a biopsy that is called a, " fusion," type biopsy then that lesion should specifically have/or will be evaluated with tissue cores. Did your urologist think your digital exam was abnormal? These are great questions to discuss with Urologist, I wish you luck.

jc

Clevelandguy

Hi,

A biopsy will determine if you have cancer and also grade its aggressiveness. As far as your lesion size, I would think it’s more important to determine if the lesion is cancerous and not how big it is. It sounds like you had your MRI in October, I would have thought by now a biopsy would have been accomplished with a Pi-rad 4 rating on the lesion.

Dave 3+4

swl1956

Sorry! I should have worded better.

I've already had two biopsies at different institutions. Yes, it's definitely cancer.

My question is:

Is a lesion with a measurement of 1.9 x 1.0 x .09 cm considered a small, medium, or large tumor? Is this is a Length x width x height measurement? Seems odd to me to measure a tumor rectangular this way. I would think a tumor being irregular in shape would be calculated differently? Any ideas?

Clevelandguy

Hi,

Don’t mean to be insensitive but does the size matter? You have been diagnosed with cancer and your medical team should provide you with a treatment plan surgical or radiation based on your Gleason score & location of the tumor. Your Prostate measured 4.8 x 3.9 x 3.6 cm and your lesion measured 1.9 x 1.0 x .09 cm  which sounds significant to me. Usually things are measured length,width,height.

Dave 3+4

Old Salt

In addition to what Clevelandguy wrote, the cancer touches the capsule; not a good thing, unfortunately.

swl1956

https://csn.cancer.org/discussion/comment/1714744#Comment_1714744

No worries about insensitivity. I am tentatively scheduled for focal ablation the end of next month. I just thought it strange how L x W x H is used on a tumor that clearly is not rectangular. In inches it converts to about 3/4" x 3/8" x 1/32". Just difficult to picture in my head with these numbers? Doesn't make sense to me?

centralPA

https://csn.cancer.org/discussion/comment/1714749#Comment_1714749

In theory the MRI can give you the actual volume of the tumor. I know it provides the actual volume of the prostate, along with the bounding box dimensions. I just have never seen them bother to specifically list tumor volume. That information is folded up into the PIRADS measurement.

swl1956

https://csn.cancer.org/discussion/comment/1714782#Comment_1714782

I don't know exactly what kind of MRI was used on me, but I would think 3D imaging would be a standard thing these days which would make possible volumetric measurements. Also seems to me, tumor size would be important when considering focal treatments. The tumor L x W x H listed on my MRI report doesn't make sense. The bounding box dimensions I can sort of understand in a 2D format but the height dimension listed of .09 cm (.035") which is thinner than a penny is counterintuitive. There must be some logic to these numbers which are just eluding me? Also seems to me that standardization of MRI reports and Biopsy results are lacking. Some I've seen on here are far more detailed than others.

centralPA

https://csn.cancer.org/discussion/comment/1714791#Comment_1714791

I think they take the longest measurement, next longest, and smallest to get those three numbers. An ellipsoid? Not sure.

Steve1961

sooo how old are you what are your thoughts on treatment plan I was diagnosed at age 57 3+4 Cribifrom psa 7.6 and I made the wrong decision. I did external beam with breakytherapy only to find out the cribiform now …is radiation resistant …so I had a relapse six years later I am one month out now of having salvage surgery and I’m doing pretty good if I could go back, I would’ve not thought twice. I would’ve got my anxiety under control and I would’ve had surgery if the cancer is contained to the prostrate it looks like yours is the gold standard and I repeat the gold standard is surgery. Look it up ….you keep the radiation in your back pocket in case you need it later on down the line , and you may not I unfortunately did it the other way around so I have another relapse. The only recourse I’ll have is the dreaded hormone treatment I know it’s confusing but then again I don’t know how old you are Age and aggressiveness has a lot to do with iwhat you choose . Good luck Surgery reslly isnt ss bad as everybody says it can be just my opinion